Opinion

Nigeria With Surplus Doctors?

Published

7 years ago

April 26, 2019

No, I am not worried (about doctors leaving the country), we have surplus. If you have surplus you export. It happened some years ago here. I was taught chemistry and biology by Indian teachers in my secondary school days. “… Who said we don’t have more than enough. You can quote me. There is nothing wrong in them travelling out. When they go abroad, they earn money and send them back home here. Yes, we have foreign exchange earnings from them and not just oil”.
Had l not watched the live interview on a national television, I would have said that the Minister of Labour and Employment, Dr Chris Ngige, who made the above statement, was quoted out of contest by journalists. But behold, even when the interviewer, who was obviously surprised at his response to a question on brain drain in the medical profession in Nigeria tried to let him know that we are facing a crisis of shortage of hands in the medical profession, he emphasized all the more that we have surplus doctors in Nigeria and any doctor that wants to leave the country should do so.
When you hear leaders like Ngige, a medical doctor, talk in this manner, you can’t help but pity the nation. If the minister of labour is not worried that we have brain drain in the medical field and its impact on the citizens but is more concerned about the money that the doctors fleeing the country everyday will bring back to the nation, are we not doomed?
According to the current recommendation of the World Health Organization (WHO), there should be one doctor per 600 persons. Here in Nigeria, however, records have it that there are 72,000 registered doctors with only 35,000 practicing in the country. With an estimated population of 180 million, it means there is one doctor per 5000 people. Yet a minister says we have surplus doctors?
Anyone who lives and uses health facilities in Nigeria, especially the public facilities, will definitely be wondering if Ngige dwells in this clime or he just came back from the moon. We all know how difficult it is to see a doctor in the public hospitals owing to the low numbers of doctors. Most times when you are going to a hospital, whether on appointment or not, you zero your mind that you are going to spend the whole day there. You can leave your house as early as 6:00 am, hoping to be among the persons to see the doctor, only to find out that over 50 patients were there before you. Sometimes you may even spend the whole day without seeing a doctor.
Not too long ago, the President, Nigeria Medical Association (NMA), Dr Francis Fadyile, lamented the disparity in doctor-patient ratio in Nigeria. He said it has remained low because the country does not retain up to 60 percent of its products. According to him, “We have doctors and other health practitioners being overworked. Where you are supposed to have ten doctors to see some number of patients, we have one doctor to all patients day in day out”. He added that, maximally, a doctor should see 42 patients a day but regrettably, a doctor sees 150 to 2000 patients in a day here in Nigeria. This has led to the death of a good number of doctors. Yet Ngige, a medical doctor who should know better, says we have more than enough doctors?
Unlike some countries where the training of medical students is beyond the reach of many families, medical schools and residencies are subsidized with government funds. This is an investment which ought to be benefitting the country and her citizens but unfortunately, other countries are now reaping from it. Countries like the United Kingdom, United States of America, Canada, Saudi Arabia, South Africa and others are constantly recruiting the best doctors, nurses, pharmacists and other health professionals from Nigeria to beef up their health sector, to the detriment of our citizens and our health sector, yet the minister of labour is not perturbed?
How can we be exporting what we have in short supply? No doubt, migration of doctors did not start today and it is not peculiar to Nigeria, but must we allow it to continue at the current alarming rate? What becomes of our citizens as the already low number of doctors and other health professionals continues to deplete daily? Contrary to the opinion of the labour and employment minister, the federal government should indeed be disturbed about the worrisome development and take urgent steps to check it.
The exodus of the doctors has been attributed to poor working environment, poor remuneration, and lack of facilities among others. Government should address these problems assiduously. There should be general improvement of the health care services, increased and adequate funding of the health sector and measures to ensure that the funds are well managed. Without these, our “surplus” doctors will continue to leave the country in droves in search of greener pastures while the likes of Ngige will continue to pretend that all is well with our health sector.

Calista Ezeaku

Opinion

Tackling Nigeria’s Health Sector Challenges

Published

15 hours ago

May 27, 2026

The Tide

Quote: “A nation’s health system is not measured by promises made, but by the quality of care available to its people when they need it most.” mm

Every year on April 7, Nigeria joins the rest of the world in commemorating World Health Day, a day dedicated to reflecting on global health challenges and strengthening healthcare systems. The occasion, which marks the anniversary of the establishment of the World Health Organization (WHO), is often accompanied by speeches and policy declarations highlighting government efforts in the health sector. This year was no different. The Minister of State for Health and Social Welfare, Iziaq Adekunle Salako, reaffirmed the commitment of President Bola Ahmed Tinubu’s administration to improving healthcare delivery. Across the states, governments showcased their interventions, with Governor Siminalayi Fubara reiterating efforts to position Rivers State as a health tourism hub. While such declarations may inspire hope, they also raise an important question: how much of this commitment is reflected in the daily realities of ordinary Nigerians?

Despite years of promises and reforms, the nation’s health sector remains burdened by structural deficiencies, inadequate funding, and policy inconsistencies. The result is a system struggling to meet the needs of a growing population. One of the most pressing challenges is the continued migration of healthcare professionals. Doctors, nurses, pharmacists, and other skilled personnel are leaving the country in large numbers in search of better remuneration, improved working conditions, and greater career opportunities abroad. This persistent brain drain has widened the gap between available healthcare workers and the population they serve. With too few professionals left to cater for millions of Nigerians, hospitals are overstretched, waiting times are longer, and the quality of care is often compromised. Rural communities suffer the most, as many health facilities lack qualified personnel, forcing residents to travel long distances for basic medical attention.

Closely linked to this challenge is inadequate funding. For decades, budgetary allocations to health have remained below internationally recommended levels. Consequently, many public hospitals operate with obsolete equipment, poor infrastructure, and shortages of essential medicines. In several facilities, healthcare workers are compelled to improvise under difficult conditions, reducing the effectiveness of service delivery. The high cost of healthcare is another major concern. With only a small percentage of Nigerians covered by health insurance, most citizens pay for medical services directly from their pockets. For many households already grappling with economic hardship, healthcare expenses can be overwhelming. As a result, people often delay treatment, resort to self-medication, or seek help from unregulated providers, worsening health outcomes and deepening poverty.

Healthcare inequality between urban and rural areas further compounds the crisis. While major cities generally have better-equipped hospitals and a higher concentration of medical professionals, many rural communities are served by underfunded or non-functional primary healthcare centres. This imbalance leaves millions of Nigerians without access to quality healthcare and reinforces existing social and economic disparities. Industrial disputes have also become a recurring challenge. Strikes by healthcare workers, often triggered by unpaid salaries, inadequate welfare packages, and poor working conditions, continue to disrupt services and put lives at risk. The recent suspension of a nationwide strike by the National Association of Resident Doctors over salary arrears, hazard allowances, and residency training funding once again highlighted unresolved issues within the sector.

Another serious concern is the proliferation of counterfeit and substandard drugs. Weak regulatory enforcement allows fake medicines to find their way into the market, undermining treatment outcomes and endangering lives. Tackling this menace requires stronger oversight, stricter sanctions, and improved coordination among relevant agencies. Addressing these challenges demands more than ceremonial speeches or periodic interventions. Healthcare is not a luxury; it is a fundamental component of national development. A healthy population is essential for economic productivity, social stability, and sustainable growth. The theme of this year’s World Health Day, “Together for Health: Stand with Science,” underscores the importance of evidence-based policymaking and investment in innovation. Advances in medical science, digital health technology, vaccines, and diagnostics have transformed healthcare globally.

Nigeria must position itself to benefit from these innovations through increased investment in research, technology, and partnerships involving government, academia, and the private sector. More importantly, there must be sustained political will to implement reforms. The Federal Government should increase budgetary allocations to health, strengthen institutions, and ensure effective implementation of healthcare policies. State governments must also recognize their responsibility in delivering quality healthcare and invest accordingly. Retaining healthcare professionals should be a top priority. Better remuneration, improved working conditions, opportunities for career advancement, and incentives for service in rural communities would help reduce the exodus of skilled personnel. Expanding health insurance coverage is equally critical to reducing out-of-pocket expenses and making healthcare more accessible to vulnerable populations.

Strengthening primary healthcare is another urgent necessity. As the first point of contact for most Nigerians, primary healthcare centres must be adequately equipped, properly staffed, and effectively managed. Investments at this level would improve health outcomes, reduce pressure on tertiary hospitals, and bring healthcare closer to the people. Ultimately, the condition of a nation’s health sector reflects its priorities. A government genuinely committed to the welfare of its citizens cannot afford to treat healthcare as an afterthought. As Nigerians mark World Health Day, attention must shift from rhetoric to action. The challenges facing the sector are well known, and the solutions are within reach. What is needed now is bold, sustained, and sincere commitment to reform. The health and wellbeing of millions of Nigerians depend on it.

2): At 59, Rivers’ Agropotential Lost?

Sylvia ThankGod-Amadi

Quote: “No society can sustainably prosper when it neglects the sector that feeds its people, creates jobs, powers industries, and secures its future.”

As Rivers State marks 59 years of its creation, there is every reason to celebrate its achievements in politics, infrastructure, commerce, education, and human capital development. Yet, amid the celebrations, one critical question demands attention: what has become of agriculture, once a major pillar of the state’s economy? Before crude oil became dominant, farming, fishing, and livestock production sustained livelihoods across communities such as Etche, Ikwerre, Ahoada, Ogba, Abua, Kalabari, Andoni, Opobo, Khana, Gokana, and Tai. Families depended on proceeds from cassava, yam, cocoyam, maize, vegetables, oil palm, fish, and other agricultural products to fund education, support households, and drive local commerce. Recognising agriculture’s importance, successive governments introduced programmes aimed at increasing food production and modernising farming.

Investments were made in extension services, fish farming schemes, livestock development, youth empowerment initiatives, and farm settlements. One notable intervention was the Songhai Farms project in Bunu-Tai, established to train young people in modern integrated farming and agribusiness. Governments also distributed improved seedlings, fertilisers, fishing equipment, and supported cooperative societies to encourage productivity and value addition. Despite these efforts, the outcomes have largely fallen short of expectations. Many projects suffered from inadequate funding, poor implementation, or policy discontinuity. Programmes launched by one administration were often abandoned by another, resulting in wasted resources and unrealised goals. At the same time, the dominance of oil revenue reduced interest in agriculture.

As opportunities expanded in the oil and gas sector, many young people abandoned farming, which gradually became associated with hardship and poverty rather than prosperity. Environmental challenges further weakened the sector. Oil spills, gas flaring, flooding, erosion, and pollution have damaged farmlands, rivers, and creeks across the state. Communities that once relied heavily on farming and fishing have seen productivity decline due to ecological degradation. These challenges continue to discourage investment and limit agricultural growth. Today, Rivers State faces a troubling paradox. Despite its vast arable land, abundant water resources, favourable climate, and large consumer market, it relies heavily on food supplies from other parts of Nigeria. Tomatoes, rice, vegetables, fish, and poultry products consumed in local markets are often transported from distant states. This dependence exposes the state to rising transportation costs, inflation, supply disruptions, and food insecurity.

Whenever insecurity, flooding, or fuel price increases affect transportation networks, food prices in Rivers State rise sharply, placing additional pressure on households. These realities highlight the urgent need for an agricultural renaissance. At 59, Rivers State must relaunch agriculture not as a political slogan but as a strategic economic priority. Such a relaunch should begin with a comprehensive agricultural master plan that transcends political administrations. Agriculture requires consistency and long-term commitment, since farmers invest over seasons rather than election cycles. Youth participation must be central to this new vision. Modern agriculture is increasingly driven by technology, mechanisation, innovation, and entrepreneurship. Greenhouse farming, aquaculture, poultry production, food processing, hydroponics, and agritech solutions have transformed agriculture into a profitable business globally.

Rivers State can establish agricultural incubation centres where young people receive training, access to land, start-up support, and mentorship, thereby creating a new generation of agripreneurs while tackling unemployment. Access to affordable finance is equally important. Many farmers struggle to secure credit because of stringent lending conditions. Government can partner with financial institutions to create specialised agricultural financing schemes offering low-interest loans and flexible repayment options. Strengthening cooperatives would also improve farmers’ access to resources, markets, and modern inputs. Infrastructure development remains critical. Good road networks linking rural communities to urban markets would reduce transportation costs and post-harvest losses. Investments in storage facilities, cold rooms, processing centres, and rural electrification would improve productivity and profitability.

Particular attention should be given to aquaculture. With its extensive rivers, creeks, wetlands, and coastline, Rivers State has enormous potential to become a major fish-producing hub, creating jobs and reducing dependence on imports. The oil palm subsector also presents significant opportunities. Before the oil boom, the Niger Delta was renowned for palm oil production. Revitalising plantations and supporting smallholder farmers can stimulate agro-industrial development, increase export earnings, and strengthen rural economies. Beyond economic gains, agricultural revitalisation offers important social benefits. Increased food production can lower food prices and improve nutrition. Job creation can reduce poverty, youth restiveness, and rural-urban migration. Agriculture also supports a wide range of value-chain activities, including transportation, processing, packaging, marketing, and equipment maintenance, creating multiplier effects throughout the economy.

Communities where young people are productively engaged are generally more stable and secure. Food security has become an increasingly urgent national concern. Recent economic challenges and inflationary pressures have exposed the risks of relying heavily on food supplies from distant locations. A state that can feed itself is better positioned to withstand economic shocks and uncertainties. As Rivers State celebrates its 59th anniversary, the occasion should inspire renewed commitment to agricultural development. The state possesses the land, water, climate, manpower, and market needed for success. What remains is the political will, strategic planning, and sustained investment required to unlock these potentials. The future prosperity of Rivers State cannot depend solely on oil revenues whose fortunes fluctuate with global market forces. Diversification is no longer optional; it is an economic necessity.

Fifty-nine years after creation, the message is clear: Rivers State must return to the land—not as a retreat to the past, but as a bold investment in a more secure, prosperous, and sustainable future. Agriculture remains one of the surest pathways to food security, employment generation, inclusive growth, and economic resilience. The seeds of that future already exist in our soil. What is needed now is the collective determination to cultivate them.

Opinion

At 59, Rivers’ Agropotential Lost?

Published

15 hours ago

May 27, 2026

The Tide

Quote: “No society can sustainably prosper when it neglects the sector that feeds its people, creates jobs, powers industries, and secures its future.”

Opinion

Monthly Environmental Sanitation Imperative

Published

1 week ago

May 18, 2026

The Tide

Quote: “A clean environment is not a government gift; it is a civic duty that protects our health, preserves our cities, and reflects our national character.”

For many Nigerians who grew up in the 1980s, 1990s, and early 2000s, the last Saturday of every month followed a familiar pattern. Roads were deserted, markets closed, and residents swept compounds, cleared gutters, cut overgrown weeds, and disposed off refuse. The monthly environmental sanitation exercise became a national ritual that promoted cleanliness, discipline, and civic responsibility. As an environment correspondent about two decades ago, I joined officials of the Rivers State Ministry of Environment on sanitation monitoring tours across Port Harcourt and surrounding communities. Although enforcement officers were sometimes accused of excesses, the exercise succeeded in creating public awareness about the importance of keeping our surroundings clean. Over time, however, the practice faded away in many states.

In its absence, indiscriminate dumping of refuse, blocked drainages and environmental neglect became increasingly common. Today, heaps of waste line roads, markets and motor parks, while gutters clogged with plastics contribute to perennial flooding. Given the mounting environmental challenges facing Nigerian cities, there is no better time to revive environmental sanitation. Its return is no longer a matter of nostalgia; it is a practical necessity for public health, environmental safety, and sustainable development. Poor sanitation remains a major cause of disease. Stagnant water and uncollected waste create breeding grounds for mosquitoes, flies and rodents, increasing the risk of malaria, cholera, typhoid and other infections. Floodwaters contaminated by refuse also expose communities to serious health hazards.

Rapid urbanisation has worsened the situation. Cities such as Lagos, Port Harcourt and Abuja are expanding faster than their waste management systems can cope. As populations grow, so does the volume of waste generated daily. Monthly sanitation exercises can help rebuild environmental consciousness. Beyond cleaning streets, they remind citizens that environmental cleanliness is a shared responsibility. They also offer an opportunity to educate children and young people about hygiene, public health and community participation. Critics argue that the old sanitation policy restricted movement and was sometimes abused by security personnel. Those concerns were valid, but they do not invalidate the concept itself. Rather than abandon it, governments should reform the programme to make it more humane, participatory and transparent.

That is why the recent decision by the Lagos State Government to reintroduce monthly sanitation deserves commendation. Even if participation is largely voluntary, the move sends a strong signal that environmental responsibility must be taken seriously. Other states should emulate this initiative. In Rivers State, the Rivers State Waste Management Agency has intensified efforts to improve waste collection and restore Port Harcourt’s reputation as the Garden City. Reintroducing monthly sanitation would complement these efforts and deepen public involvement. At the federal level, policies such as the Digital Waste Marketplace, the Plastic Waste Policy and the National Waste Management Network are commendable. However, environmental sanitation remains one of the most direct and visible ways to mobilise citizens toward cleaner communities.

The exercise, however, must be supported by efficient waste management infrastructure. Citizens cannot be expected to maintain clean surroundings if there are inadequate waste bins, irregular refuse collection, and limited recycling facilities. Governments at all levels should invest in modern waste management systems, properly fund sanitation agencies, and promote recycling programmes. Waste sorting should become standard practice to reduce the volume of refuse ending up in landfills and drainage channels. Countries such as Singapore, Sweden and South Korea have demonstrated that waste can become a valuable economic resource. Recycling industries in these countries create jobs while protecting the environment. Nigeria can adopt similar strategies and turn waste into wealth.

Environmental laws must also be enforced consistently. Regulations against illegal dumping exist in many states but are rarely implemented. Offenders should face penalties, but enforcement must be fair and free from extortion. Urban planning is another critical factor. Poor drainage systems, overcrowding and inadequate sewage infrastructure worsen sanitation problems. Governments must prioritise road construction, drainage maintenance and orderly urban development. Markets deserve particular attention. They generate enormous quantities of waste every day, yet many lack organised disposal systems. Local councils and market associations should work together to establish effective waste collection arrangements in commercial centres. Religious institutions, schools, traditional rulers and civil society groups also have important roles to play.

Environmental responsibility should be taught and reinforced as a social value. Community leaders can help change attitudes by consistently promoting cleaner habits. This issue is even more urgent in an era of climate change. Flooding, erosion and extreme weather events are already threatening many Nigerian communities. Poor waste disposal worsens these challenges by blocking waterways and reducing urban resilience. A clean environment also offers economic benefits. Well-maintained cities attract investors, tourists and businesses. Reduced disease outbreaks lower healthcare costs and improve productivity among workers and students. More importantly, cleanliness reflects national values. A nation that allows public spaces to deteriorate projects an image of disorder and neglect. Nigerians deserve cleaner streets, healthier neighbourhoods and safer communities.

Reviving environmental sanitation will not solve all environmental problems overnight, but it can serve as a powerful starting point. Combined with effective waste management, public education and stronger infrastructure, it can restore environmental consciousness across the country. Ultimately, environmental cleanliness is a shared responsibility. Government must provide leadership, infrastructure and enforcement, while citizens must demonstrate discipline and civic commitment. From disposing of household waste properly to keeping drains free of obstruction, every Nigerian has a role to play. If Nigeria is serious about protecting public health, reducing flooding and building livable cities, the return of monthly environmental sanitation is a step whose time has come.

By: Calista Ezeaku